Banca de DEFESA: CESAR FREIRE DE MELO VASCONCELOS

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : CESAR FREIRE DE MELO VASCONCELOS
DATE: 14/11/2022
TIME: 08:00
LOCAL: VIDEO CONFERENCIA
TITLE:

EVALUATION OF BILATERAL R5-R8 THORACIC SYMPATHECTOMY USING LIFE QUALITY INDEX IN PATIENTS WITH SEVERE COMPENSATORY HYPERHIDROSIS

KEY WORDS:

Sympathectomy. Hyperhidrosis. Sweating. Quality of life. Thoracic surgery. Sympathetic Nervous System

PAGES: 72
BIG AREA: Ciências da Saúde
AREA: Medicina
SUMMARY:

Objective: To investigate the quality of life (QoL) of patients who developed severe compensatory hyperhidrosis, after sympathectomy for localized sweating, with a new approach using the modified technique of bilateral thoracic sympathectomy at the R5-R8 level. Methods: Eighteen patients with severe compensatory hyperhidrosis underwent the modified procedure of bilateral thoracic sympathectomy at the level of R5-R8, by video thoracoscopy, localized in the palmar and axillary region, in the period from 2015 to 2020, from thoracic surgery services of reference hospitals in Recife, Pernambuco. The outcomes were: quality of life and possible surgical complications. To assess QL, a questionnaire was used and applied twice, the first on the overall QL preoperatively (T=0) and the second comparing QL 30 days postoperatively (T=1) and late postoperatively over four months (T=2). The questionnaire consisted of 20 questions divided into four domains (functional-social, personal, emotional, and unique conditions), which allowed only one answer for each question. The patients were classified into five levels of satisfaction obtained by adding up the points on the questionnaire. As for the operative technique, all patients were submitted bilaterally in a single approach. It was started by the left hemithorax, positioning the patient in right lateral decubitus with a cushion under the thorax and contralateral arm. Results: Age ranged from 22 to 47 years, with a mean of 31.33 years, a standard deviation of 6.89 years, and a median of 30.50 years. The association between the two assessments on QL 16 of 18 patients (88.9%) was: slightly better (22.2%) or much better (66.7%) when comparing T0 with T1. However, two patients (11.1%) with poor QL (T0) reported some worsening in the first postoperative month (T1). In the late observation (T2), there was an analysis of 10 patients, two patients (20%) reported worsening symptoms after surgery, and 80% showed improvement in symptoms. The means and medians of QL and function domains were correspondingly higher T0 when compared to T1 and T2, the differences with statistical significance. Conclusions: The proposed technique improved patients' quality of life with compensatory hyperhidrosis at all analyzed times. In addition, the minimally invasive approach of the technology enables reduced surgical time, better ergonomics, superior aesthetic results, and lower postsurgical morbidity.

COMMITTEE MEMBERS:
Presidente - 1204998 - ALVARO ANTONIO BANDEIRA FERRAZ
Externo ao Programa - 3315821 - EUCLIDES DIAS MARTINS FILHO - nullInterno - 2433058 - FLAVIO KREIMER
Interna - 4315699 - MARIA INES REMIGIO DE AGUIAR
Externa ao Programa - 2247580 - MICHELLY CRISTINY PEREIRA - null